March 11 Update

In This Week’s Update:

  • Analysis of State-Based Marketplaces
  • RWJF Medicaid Briefing Series
  • State Updates: AZ, CA, CO, NE, NM, PA, VT & VA
  • CSR Litigation and State Options
  • Promoting Health and Cost Control
  • State of Babies

Analysis of State-Based Marketplaces

Last week, Covered California, the Massachusetts Health Connector and the Washington Health Benefit Exchange together produced a new report that outlines the benefits of state-based exchanges, particularly in the areas of controlling premium costs and attracting new enrollment. The report examines how state and federal actions affected premiums and new enrollment, and finds that premium increases in these states were less than half of what consumers saw in the 39 states that relied on the federally facilitated marketplace (FFM) between 2014 and 2019.

RWJF Medicaid Briefing Series

Also last week, with funding from the Robert Wood Johnson Foundation, Manatt Health released a series of seven briefs on key Medicaid issues. The Medicaid Briefing series is designed to assist state policymakers in understanding the Medicaid program and their role in using it to improve the health of their states’ residents and communities. For those of you working within Medicaid, this series should be informative and we encourage you to share it with fellow Medicaid colleagues.

State Updates: AZ, CA, CO, NE, NM, PA, VT & VA

  • Arizona – The Arizona Health Care Cost Containment System is co-hosting a Medicaid Innovation Challenge on March 29, 2019. The Challenge is an opportunity for vendors to collaborate with integrated managed care organizations to discuss what value their solutions can bring to Arizona Medicaid in addressing social determinants of health and digital member engagement. Register to watch the Challenge on a live stream.
  • California – Governor Gavin Newsom appointed practicing pediatrician and director of health and social impact for Los Angeles County Mark Ghaly as his secretary for the California Health and Human Services Agency.
  • Colorado – Connect for Health Colorado, the state’s official health insurance marketplace, is compiling the findings from an evaluation of its new eligibility determination system which was launched during the most recent open enrollment period. In addition to interviewing customers, brokers and other stakeholders, Connect for Health also engaged experts to review the website and eligibility application.
  • Nebraska – The Nebraska Department of Health and Human Services has partnered with Nebraska 2-1-1 to provide information regarding referral to services for moms and babies throughout the state. This partnership means parents will continue to get the helpful information and referrals just like they did with the helpline, but in addition, they can also be directed to other relevant services and support systems that are offered.
  • New Mexico – The New Mexico Health Insurance Exchange, also known as beWellnm, issued a request for proposals for a contractor to develop, supply, implement, host, maintain, and provide end user support to individual marketplace operations, including technology, financial management and billing, customer engagement center, and mailroom functions, and best in class account management. Proposals are due April 1.
  • Pennsylvania – The Wolf Administration announced the first five participants in the Pennsylvania Rural Health Model, an alternative payment model, that will transition hospitals from a fee-for-service model to a global budget payment. Payment for the global budget will include multiple-payers, including private and public insurers.
  • Vermont – The Department of Vermont Health Access released a summary of the state’s 2019 individual enrollment. In five graphs, the state shared key takeaways including that overall enrollment was stable and that young adults took advantage of increased subsidies.
  • Virginia – Cover Virginia has launched a new website designed to provide consumers with a better experience on their smart phone, tablet and computer to facilitate navigation of the site. The website is now mobile-friendly and checking eligibility is easier as a result of a streamlined screening tool.

Upcoming Webinar- Leveraging Multi-Payer Claims Databases for Value

Wednesday, March 27, 2019 from 3:00 to 4:00 p.m. ET

More states are leveraging multi-payer claims databases to better understand how their health care systems are operating and implementing data-driven decision-making. States may not be aware, however, of the strategies other states and organizations are adopting to leverage claims databases to support health care transformation goals. State Health and Value Strategies, in partnership with the Peterson Center on Healthcare, will host a webinar on the ways in which several states and one community organization are using their multi-payer claims databases. During the webinar, presenters from the state of Vermont and Rhode Island, as well as the Washington Health Alliance, will discuss how they are employing claims databases to enhance the value of care and will share lessons learned for those seeking to optimize their own databases.

Registration (required) at the following link:


What, if Anything, Do the Latest Cost Sharing Reduction (CSR) Court Rulings Mean for 2020 Premiums?

In case you missed it, Sabrina Corlette, from Georgetown University’s Center for Health Insurance Reforms, wrote a new Expert Perspective on the SHVS website. The post provides a brief background on the recent litigation surrounding  cost sharing reductions, including executive actions, and state and insurer responses, as well as what could potentially happen next and what it means for states. The post also provides state options to proactively take action as it relates to 2020 silver loading and premium rate setting.


How States Can Improve Community Health and Well-Being Through Promoting Health and Cost Control

Trust for America’s Health released a new report last week, Promoting Health and Cost Control: How States Can Improve Community Health and Well-Being Through Policy Change, that highlights 13 evidence-based policies to improve the health and well-being of state residents. The report is the first publication of the Promoting Health and Cost Control in States (PHACCS) initiative, which identifies policies for good health that look beyond health care, part of a larger effort to foster cross-sector collaboration, given that changes to any policy area can impact the population’s well-being and states’ ability to control costs. The policies highlighted in the report provide a menu of options for state leaders to explore and provides detailed information on the recommended policies, including summaries of the health and economic evidence, case examples, and considerations for implementation.

Health and Wellbeing of Babies, State-By-State

ZERO TO THREE and Child Trends released the State of Babies Yearbook: 2019 which provides state-by-state and national data on the well-being of America’s infants and toddlers. The Yearbook compiles nearly 60 indicators—specifically for children ages 0 to 3—to measure progress in the domains of Good Health, Strong Families, and Positive Early Learning Experiences. Using a transparent ranking process to group states into one of four tiers, the Yearbook provides a quick snapshot of how states fare on the selected indicators and domains.